A photograph depicting a young patient in CHOC Children’s neonatal intensive care unit (NICU) participating in a music therapy session has earned a spot in a national photo exhibit showcasing how children’s hospitals help kids thrive.
The biennial Children’s Hospitals Photo Exhibit, the result of a national competition administered by the Children’s Hospital Association (CHA), curates 50 photographs selected by a panel of distinguished judges including renowned photographer and author Anne Geddes.
In CHOC’s winning photo illustrates the power of music therapy, which helped the patient, Olivia, manage pain, self-soothe and express herself. Olivia, who spent the first seven months of her life in the NICU, became more relaxed every time she worked with CHOC music therapist Brie Mattioli.
“Music promotes a sense of positivity, peace and normalcy in the room,” Brie says. “It wasn’t the nursery [her parents] planned to bring their baby home to, but it provides a sense of normalcy to families.”
The exhibit of 50 winning photographs was curated by a panel of distinguished judges including renowned photographer and author Anne Geddes. Showcasing the ways children’s hospitals help all children thrive, the online exhibit includes stories behind the photos, allowing viewers to read first-hand accounts from patients, parents, doctors and other healthcare providers.
Tamara Wroclawsky’s photograph was chosen from more than 370 images submitted by nearly 60 children’s hospitals across the country.
Joining Geddes on the judging panel were Sandy Adams, photo journalist and officer, The Exposure Group; Lily Francesca Alt, photo director, PARENTS magazine; Lori Epstein, photo director, National Geographic Kids Books; and Eric Gapsch, graphic designer, CHA.
CHOC Children’s has joined The Beryl Institute’s newly formed Pediatric Council, which represents a group of individuals committed to engaging with one another, sharing ideas and expanding the engagement of pediatric patient experience leaders in the Institute’s community.
Members of the Institute’s Pediatric Council are passionate about the advancement of pediatric patient experience and ensuring resources are available to support pediatric leaders in advancing the human experience in healthcare. The Pediatric Council will guide program development and advise The Beryl Institute on topics of relevance and issues pertaining to pediatric leaders and staff.
CHOC Customer Service Manager Sandra Schultz was recently certified as a patient experience professional through the Patient Experience Institute (PXI) and has been selected to serve on the Pediatric Council.
An independent, nonprofit organization committed to improving the patient experience through evidence-based research and professional development, PXI is a sister organization of The Beryl Institute, a global community similarly dedicated to improving the patient experience through collaboration and shared knowledge.
According to PXI, a certified patient experience professional (CPXP) is a leader who influences the systems, processes and behaviors that cultivate consistently positive experiences as defined by patients and families across the continuum of care. An international designation, CPXP certification highlights a commitment to the profession and to maintaining current skills and knowledge in supporting and expanding the field of patient experience.
As a member of the Pediatric Council, Schultz joins other industry leaders across the nation committed to engaging with one another, sharing ideas and expanding the engagement of pediatric patient experience.
“I am honored to serve on The Beryl Institute’s Pediatric Council and look forward to exchanging best and innovative practices that will further enhance the patient experience at CHOC,” Schultz said.
CHOC’s long-standing commitment to providing the best possible patient and family experience is guided by the principles of dignity and respect, information sharing, participation and collaboration. Feedback is actively solicited through surveys and forums, such as the Family Advisory Council, an important group of adult family members from a variety of backgrounds and family types who meet regularly to provide input on hospital initiatives.
As the world celebrates International Women’s Day, we turned to CHOC Children’s female physicians and nursing leaders for insight and words of encouragement to other women pursuing healthcare careers.
Melanie Patterson, vice president, patient care services, and chief nursing officerWhen beginning your career in medicine, don’t focus on one trophy. The fields of medicine and nursing have so many opportunities within them; be courageous and try new things. The most important aspect of leadership and of career success is to be kind. Remember to form your own opinion — go into every relationship with your eyes open and stop looking through others’ eyes; they don’t always have 20/20 vision.
Dr. Mary Zupanc, pediatric neurologist and epileptologist & co-medical director of the CHOC Children’s Neuroscience Institute
When I went to medical school, women were not encouraged, and it was hard. There were a lot of things that happened that made it very difficult, but medicine is truly one of the most gratifying professions you will ever have. Every patient is different. I believe that if you really and truly listen, a patient and their family will give you the diagnosis you’re searching for. Everyone’s story is so fascinating, and that makes our work like being a detective. Sometimes I feel like Sherlock Holmes searching for answers. Then once you do find an answer, you need to work with the family to make sure the treatment works for their lifestyle, culture and religion. That makes the work challenging, fun and meaningful.
The best piece of advice that I’ve ever received is to never apologize for excellence. Anyone would want their doctor to strive for excellence – and that goes for any profession.
Amy Waunch, nurse practitioner and trauma program managerNever underestimate your capabilities. Do not shy away from opportunities and always take on new challenges. Believe in yourself but don’t be afraid to ask for help. You may not have all of the answers all of the time, but you do have the ability to learn and grow.
Spot growth opportunities when they present themselves because they are the key learning opportunities. You will know because they make you uncomfortable and your initial impulse will be that you are not ready.
Dr. Azam Eghbal, medical director, radiologySince I was 7 years old, I wanted to be a doctor and becoming one has been the best decision of my life. As a female immigrant, I was told that I could never get to medical school, which, of course, motivated and challenged me even more to do so. The best advice I’ve gotten is don’t be discouraged about all your falls and obstacles. Think how you can succeed to get where you want to be.
Dr. Amber Leis, pediatric plastic surgeonMy advice for women pursuing a career in medicine is to trust yourself! Early on in your career, it’s easy to be overcome by feeling like you are not up to the task ahead of you. Your unique qualities will become your greatest strengths, so just keep chasing your passion.
I have great faith that if I stay true to my core principles, the right path will open in front of me. I try not to set specific goals for the future and instead I give my best to where I am. It keeps me focused on what I am doing now, and not distracted by trying to maneuver into some future place.
The best piece of career advice I’ve ever gotten has been, “You get to choose what kind of person you will be.”
Dr. Jasjit Singh, medical director, infection prevention & controlMy advice for women pursuing a career in medicine is to follow your passion! There are few other careers that offer the personal satisfaction and the intellectual rigor that medicine does. Find a good mentor early in your career. Later, make sure your practice partners have abilities that you respect, and the talent to make your shared time together meaningful.
I learned early on that delegation and time management are important, particularly if you want to balance a medical career and family. You can’t always do it all, and prioritization is tantamount to success in all the different spheres of your life.
One of the best pieces of advice that I got was from a mentor during fellowship, who told me, “It’s not enough to just be a good clinician.” He showed me the importance of asking good research questions and pursuing new knowledge. He also encouraged my love of teaching upcoming generations of pediatricians!
Dr. Katherine Williamson, pediatricianI love being a pediatrician. I help take care of kids every day and partner with their parents to help keep them healthy. To me, being successful is loving what you do, because then working hard and being motivated to do well doesn’t feel like work – it’s fulfilling a passion.
When asked to give advice, I always say these three things: be yourself, don’t rush, and follow your heart every step of the way. Be yourself, always. No matter how busy or loud life gets, never lose sight of you who you are and what you want to do. Don’t be in a rush. Enjoy the journey because that is where you learn who you truly are. Lastly, follow your heart in every decision you make. When I look back on what got me to where I am in my career, I realize that it was not one or two big decisions that were the deciding factor, but instead it was a million little decisions along the way. And with each of those decisions I followed my heart and my passion.
Obese children who regularly participate in CHOC Children’s mobile asthma program could realize good control of their asthma, a retrospective study of more than 1,200 patients reveals.
Study findings showed no difference in the time it took for morbidly obese children and children with normal weights to reach asthma control – so long as they didn’t exceed 90 days between Breathmobile visits.
Dr. Stanley Galant, CHOC allergist/immunologist and Breathmobile medical director, presented these findings at the American Academy of Allergy, Asthma & Immunology (AAAAI) recent annual meeting. This work, “Can asthma be well controlled with NAEPP guideline care in morbidly obese children? The Breathmobile,” was also published in the Annals of Allergy, Asthma & Immunology.
The study examined 1,204 children ages 3 to 18 who were diagnosed by a physician with asthma between 2003 and 2012. Of the patients, more than half were considered overweight, obese or morbidly obese.
About 80 percent of Breathmobile patients achieved well-controlled asthma by their third visit. Additionally, participants across all body mass index (BMI) categories saw at least a 60 percent reduction in the likelihood of emergency department visits, hospitalizations, school absences and exercise limitations, even without a change in their BMIs.
CHOC’s Breathmobile is the only mobile asthma clinic dedicated to serving preschool and school-aged children in Orange County. An important community service, it removes barriers for children and their families who may be unable to travel or pay for preventive asthma care.
The Breathmobile’s two 36-foot RV-style clinics travel to 22 schools and community sites providing asthma care, diagnosis and education. Each location is visited every four to six weeks, providing children with comprehensive follow-up care from a familiar team until their asthma is controlled.
In his presentation, Dr. Galant attributed the Breathmobile’s success to cultural compatibility; patient access to community-based specialty care; adequate education for self-management; and most important, continuity of care, particularly for patients considered morbidly obese.
One year ago, a group of CHOC Children’s physicians gathered to begin the process of defining and building a meaningful wellness program throughout the health system.
As many know, physician burnout has become of great concern, and we are only beginning to appreciate the scope of this phenomenon, including the impact of burnout on ourselves, our patients and our colleagues, in addition to the complexity of issues involved. More importantly, we struggle with identifying the signs and symptoms leading to burnout, and how best to address them.
A recent survey of more than 15,000 physicians found that 44 percent of physicians reported symptoms of burnout, 11 percent reported subclinical depression, and 4 percent reported clinical depression. The gender disparity is notable, with 39 percent of males compared to 50 percent of female physicians experiencing burnout. The factors that lead to burnout are complex, and range from bureaucratic tasks and long work hours, to the challenges of electronic medical record keeping and loss of control/autonomy.
Coping strategies vary and include a number of activities, including exercise, talking with close friends and family, and ensuring adequate diet and sleep. But sometimes these approaches aren’t enough.
Depressive symptoms can begin to emerge, leading to more serious functional impairment. If left unchecked, clinical depression can result. Unfortunately, many physicians contemplate suicide. It is estimated that one doctor a day dies by suicide in the United States, the highest rate of any profession1. Even more concerning is that of those physicians who report suicide ideation, 42 percent do not tell anyone or get professional help2. Obviously, this needs to be addressed, and it needs to be addressed now.
CHOC’s Physician Wellness Subcommittee is comprised of a group of physicians dedicated to help CHOC continue to be proactive and supportive of physicians. Our mission, “To promote physician wellness to benefit ourselves and others,” captures our focus. We have been meeting since January 2018 and have established several key goals with the Stanford Medicine Model of Wellness, below, as a guide3.
Using the key areas as a guide, we have determined the following short-term goals to address each area below:
Personal Resilience: A “Wall of Gratitude” displayed in the physician dining room (PDR) will give physicians a platform to recognize colleagues in an informal format posting words of appreciation and encouragement to one another.
Efficiency of Practice: Improvements to the computer work station in the PDR will ease charting while also gaining needed nourishment. Results of an EMR survey, conducted with the ARCH Collaborative, will provide us with specific and targeted data that will allow us to address common EMR frustrations and issues to help increase our efficiency.
Culture of Wellness: We are in the beginning phases of planning a “refresh room” where physicians can go to recharge, meditate and decompress. We’ve also made some improvements to the coffee machine in the PDR.
Additional long-term goals include:
Peer-to-peer mentorship training
Optimizing EMR practices
Gathering Information from physicians willing to help to improve our culture of wellness
Another noteworthy CHOC-supported activity that helps to meet our Personal Resilience and Culture of Wellness goals includes restoring the joy of practice through the Communication in Healthcare seminar that we’ve deployed. Approximately 60 physicians and additional allied health providers have completed the patient communication program. Participants have reported extremely positive feedback and state the training has increased their sense of fulfillment, communication efficiency, and overall resulted in more meaningful relationships with their patients.
While there is much work to be done, we are grateful for the support we have received from CHOC, and are confident, with our collective effort, that a culture of wellness is achievable.
If you would like to help in our efforts, reach me at 714-509-8225.
1Anderson P. Doctors’ suicide rate highest of any profession. WebMD. May 18, 2018. Source Accessed February 28, 2019.
2Pappas S. Suicide: Statistics, warning signs and prevention. LiveScience. August 10, 2017. Source Accessed February 28, 2019.
3Bohman, B., Dyrbye, L., Sinsky, C., Linzer, M., Olson, K., Babbott, S., & Trockel, M. (2017). Physician well-being: the reciprocity of practice efficiency, culture of wellness, and personal resilience. NEJM Catalyst.